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Updated: Mar 1, 2026

Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
Published on: August 8, 2025
Strategies to Traverse the Arm and Chest Vasculature
Tejas M Patel1, Sanjay Shah1, Samir B Pancholy2
1Apex Heart Institute, S. G. Road, Ahmedabad 380 054, India; Department of Cardiology, Sheth V.S. General Hospital, Smt. N.H.L. Municipal Medical College, Ellisbridge, Ahmedabad 380 006, India.
Abstract:
This article discusses different methods of working through arm and chest vasculature to increase the success rate of the transradial approach (TRA). Despite lower rates of bleeding and vascular complications as compared with the transfemoral approach, adoption of the TRA has been slow, particularly because of higher failure rates. Anatomic complexities of arm and chest vasculature play an important role in cases of TRA failure. Using a simple framework to classify the anatomic or functional problem and approaching these challenges in a logical sequence should facilitate management and increase the success rate for TRA.
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